CN109700527B - Model establishing method and model of aortic dissection and simulated surgery detection method - Google Patents
Model establishing method and model of aortic dissection and simulated surgery detection method Download PDFInfo
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- CN109700527B CN109700527B CN201910003999.8A CN201910003999A CN109700527B CN 109700527 B CN109700527 B CN 109700527B CN 201910003999 A CN201910003999 A CN 201910003999A CN 109700527 B CN109700527 B CN 109700527B
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Abstract
The invention provides a model building method and a model of an aortic dissection and a simulated surgery detection method. The model establishing method comprises the following steps: obtaining CTA image data of a patient's aorta; establishing a three-dimensional model of an aortic dissection according to the obtained CTA image data of the aorta of the patient; 3D printing is carried out according to the three-dimensional model, and the aortic dissection model is made of transparent materials consistent with the elasticity of the blood vessels of the patient; a pressure sensor is arranged on the inner side of the tube wall of the aorta of the aortic dissection model, and a flow sensor is arranged at the outlet of the arterial branch of the aortic dissection model. Thus, the physician can perform the simulated operation before performing the actual operation.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to an aortic dissection model establishing method, an aortic dissection model and a simulated operation detection method.
Background
In cardiovascular diseases, the aortic dissection is far more dangerous than other cardiovascular diseases due to complex clinical manifestations, rapid disease progression, high surgical difficulty, high technical requirements and the like. Aortic dissection is a vascular disease in which the intima of the vessel wall is partially torn under the impact of blood flow and is continuously impacted by arterial blood, so that the intima is gradually stripped off and a blood flow cavity is formed between the original intima and adventitia. If aortic dissection is not treated in time, nearly half of patients with acute Stanford type a aortic dissection die within 3 days, the mortality rate reaches 80% in 2 weeks, and the mortality rate of patients with Stanford type B aortic dissection at high risk can exceed 70% in 30 days.
At present, the aortic dissection treatment is based on active medical drug treatment, and then the aortic endoluminal repair is performed. In the aortic endoluminal repair, a covered stent is placed to close a proximal groove of an aorta, so that the formation of thrombus in a false lumen is promoted, the blood supply perfusion of a true lumen is increased, better aortic remodeling is obtained, and the risk of aortic rupture is reduced. The use of this treatment modality allows the patient to reduce or avoid the surgical risk of surgical aortic replacement to some extent.
With the development and progress of medical technology, aortic dissection endoluminal repair is mature, but still is a traumatic and dangerous treatment means. The causes of aortic dissection diseases are complex and changeable, the physical properties and morphological characteristics of the aorta of the aortic dissection diseases can be changed to different degrees along with the development of the diseases, when doctors perform surgical operations on patients, the aortic dissection endoluminal repair can be completed only by the past experience, and if deviation occurs in the stent release process, the prognosis effect of the patients is seriously influenced. Therefore, how to provide a bionic training system which can help a doctor to be familiar with the personalized interventional therapy operation of a patient before the doctor carries out aortic dissection intraluminal repair on the patient has very important significance.
Disclosure of Invention
In view of the above, the present invention provides a model building method, a model and a simulated surgery detection method for aortic dissection, so as to enable a physician to perform a training operation before performing a surgery operation.
In a first aspect, an embodiment of the present invention provides a method for building a model of an aortic dissection, including:
obtaining CTA image data of a patient's aorta;
establishing a three-dimensional model of an aortic dissection according to the obtained CTA image data of the aorta of the patient;
3D printing is carried out according to the three-dimensional model, and the aortic dissection model is made of transparent materials consistent with the elasticity of the blood vessels of the patient;
a pressure sensor is arranged on the inner side of the tube wall of the aorta of the aortic dissection model, and a flow sensor is arranged at the outlet of the arterial branch of the aortic dissection model.
With reference to the first aspect, an embodiment of the present invention provides a first possible implementation manner of the first aspect, where the disposing a pressure sensor on the aortic dissection model includes:
determining the number and the positions of pressure sensors to be placed in the aortic dissection model according to the position relation of a false cavity of the aortic dissection and a thoracic aorta and an abdominal aorta in the aortic dissection model; placing the pressure sensors on the aortic dissection model in the determined number and location.
With reference to the first possible implementation manner of the first aspect, the present invention provides a second possible implementation manner of the first aspect, wherein the number and the positions of the pressure sensors to be placed in the aortic dissection model are determined according to the position relationship between the false cavity of the aortic dissection and the thoracic aorta and the abdominal aorta in the aortic dissection model; placing the pressure sensors on the aortic dissection model in the determined number and location, comprising:
when the lower port of the false cavity of the aortic dissection is positioned at the upper half section of the thoracic aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, and two pressure sensors are correspondingly arranged on the inner side of the tube wall at the tail end of the thoracic aorta;
when the lower port of the false cavity of the aortic dissection is positioned at the upper half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the true cavity at the tail end of the thoracic aorta, and two pressure sensors are correspondingly arranged in the false cavity;
when the lower port of the false cavity of the aortic dissection is positioned at the lower half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the tail end of the thoracic aorta, two corresponding pressure sensors are arranged on the inner side of the tube wall of the tail end of the abdominal aorta, and a pair of pressure sensors are correspondingly arranged in the middle and the lower part of the inner side of the tube wall in the false cavity respectively.
With reference to the first aspect, an embodiment of the present invention provides a third possible implementation manner of the first aspect, where the setting of a flow sensor at an outlet of an arterial branch of the aortic dissection model includes:
ultrasonic flow meters are correspondingly arranged at branch outlets of the innominate artery, the left common carotid artery, the left subclavian artery, the celiac trunk artery, the superior mesenteric artery, the left renal artery, the right renal artery, the left common iliac artery and the right common iliac artery of the aortic dissection model.
In a second aspect, an embodiment of the present invention further provides an aortic dissection model, which is manufactured by applying the method according to any one of the first aspect, and includes: an ascending aorta portion, an aortic arch portion, a thoracic aorta portion, an abdominal aorta portion, a sandwich portion, and an arterial branch portion; the wall of the aorta is provided with a pressure sensor, and the branch outlet of the artery branch part is provided with a flow sensor.
With reference to the second aspect, the embodiment of the present invention provides a first possible implementation manner of the second aspect, wherein when the lower port of the prosthetic cavity of the aortic dissection is located in the upper half section of the thoracic aorta, two pressure sensors are correspondingly arranged on the inner sides of the tube walls of the middle and rear sections of the aortic arch, and two pressure sensors are correspondingly arranged on the inner sides of the tube walls of the distal end of the thoracic aorta;
when the lower port of the false cavity of the aortic interlayer is positioned at the upper half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the true cavity at the tail end of the thoracic aorta, and two pressure sensors are correspondingly arranged in the false cavity;
when the lower port of the false cavity of the aortic dissection is positioned at the lower half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the tail end of the thoracic aorta, two corresponding pressure sensors are correspondingly arranged on the inner side of the tube wall of the tail end of the abdominal aorta, and a pair of pressure sensors is correspondingly arranged at the middle part and the lower part of the inner side of the tube wall in the false cavity respectively.
In combination with the second aspect, the present invention provides a second possible implementation manner of the second aspect, wherein the artery branching portion includes: innominate artery branch, left common carotid artery branch, left subclavian artery branch, celiac trunk artery branch, superior mesenteric artery branch, left renal artery branch, right renal artery branch, left common iliac artery branch and right common iliac artery branch; ultrasonic flow meters are respectively arranged at the score outlets of the innominate artery branch, the left common carotid artery branch, the left subclavian artery branch, the celiac trunk artery branch, the superior mesenteric artery branch, the left renal artery branch, the right renal artery branch, the left common iliac artery branch and the right common iliac artery branch.
In a third aspect, the embodiment of the invention provides a monitoring method for aortic dissection repair simulation surgery,
the aortic dissection repair simulation procedure is performed on a model of the aortic dissection, the method comprising:
after a simulated operation starts, acquiring pressure data and flow data which are respectively acquired by each pressure sensor and each flow sensor on the model of the aortic dissection in the simulated operation process, wherein the pressure data carries an identifier of the pressure sensor, and the flow data carries an identifier of the flow sensor;
after the simulation operation is finished, enabling each pressure sensor and each flow sensor to acquire steady-state data within a preset time, and storing the data acquired by each pressure sensor and each flow sensor;
after the data storage is finished, generating a surgical report according to the stored data collected by each pressure sensor and each flow sensor;
and outputting the operation report.
With reference to the third aspect, an embodiment of the present invention provides a first possible implementation manner of the third aspect, where the method further includes:
comparing the acquired pressure data of the simulated operation process acquired by each pressure sensor with a preset first data threshold range respectively to obtain a first comparison result of the simulated operation process;
comparing the acquired pressure data of the simulated operation result acquired by each pressure sensor with a preset second data threshold range respectively to obtain a second comparison result of the simulated operation result;
comparing the acquired flow data of the simulated operation process and the acquired flow data of the simulated operation result acquired by each flow sensor with a preset third data threshold range respectively to obtain a third comparison result of the simulated operation process and a third comparison result of the simulated operation result;
after the simulated surgery is finished, generating a surgery report according to the stored data collected by each pressure sensor and each flow sensor, wherein the method comprises the following steps:
after the simulated operation is finished, judging the simulated operation process and the possible risks after the simulated operation according to the stored data collected by each pressure sensor and each flow sensor, the first comparison result, the second comparison result and the third comparison result.
With reference to the first possible implementation manner of the third aspect, the present invention provides a second possible implementation manner of the third aspect, wherein,
judging a first risk degree of vascular rupture at the position where the pressure sensor is located according to the first comparison result;
judging a first risk degree of vascular rupture and a second risk degree of thrombus growth at the position where the pressure sensor is located according to the second comparison result;
judging a third risk degree of the organ supplied with blood by the artery branch corresponding to the artery branch outlet where the flow sensor is positioned in a transient ischemic state according to the third comparison result;
after the simulated surgery is finished, generating a surgery report according to the stored data collected by each pressure sensor and each flow sensor, wherein the method comprises the following steps:
after the simulated surgery is finished, generating a surgery report according to the stored data collected by each pressure sensor and each flow sensor, the first comparison result, the second comparison result, the third comparison result, the first risk degree, the second risk degree and the third risk degree.
According to the aortic dissection model establishing method, the model and the simulated operation detection method provided by the embodiment of the invention, the model for training operation can be provided for a doctor by the method for establishing the aortic dissection model, so that the doctor can perform the training operation firstly when performing the actual operation, and then the doctor can be allowed to optimize the actual operation according to the process of the training operation, and the success rate of treatment is improved.
In order to make the aforementioned and other objects, features and advantages of the present invention comprehensible, preferred embodiments accompanied with figures are described in detail below.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present invention and therefore should not be considered as limiting the scope, and for those skilled in the art, other related drawings can be obtained according to the drawings without inventive efforts.
FIG. 1 is a schematic diagram showing the structure of a model of aortic dissection according to an embodiment of the present invention;
FIG. 2 is a schematic diagram showing the structure of another aortic dissection model provided by the embodiment of the invention;
FIG. 3 is a schematic structural diagram of a model of an aortic dissection provided in accordance with an embodiment of the present invention;
fig. 4 is a flow chart illustrating a monitoring method for aortic dissection simulation surgery according to an embodiment of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. The components of embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations. Thus, the following detailed description of the embodiments of the present invention, presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments of the present invention without making any creative effort, shall fall within the protection scope of the present invention.
First, in an embodiment of the present invention, a method for establishing a model of an aortic dissection is provided, which includes the following steps a10-a 40:
step a10, CTA image data of the aorta of a patient is acquired.
Firstly, a patient needing aortic dissection repair surgery is subjected to angiography, and CTA image data containing an aortic dissection of the patient is obtained.
And A20, establishing a three-dimensional model of the aortic dissection according to the obtained CTA image data of the aorta of the patient.
In this embodiment, a three-dimensional model of the aortic dissection is created from CTA image data of the aorta of the patient using 3D image generation and editing processing software.
And A30, performing 3D printing according to the three-dimensional model, and manufacturing the aortic dissection model by using a transparent material consistent with the elasticity of the blood vessel of the patient.
In this embodiment, after obtaining the three-dimensional model of the aortic dissection, a 3D printer is used, and a transparent material similar to or consistent with the elasticity of the blood vessel of the patient, such as silica gel, siloxane, polyurethane, etc., is used.
The aortic dissection model corresponds to the structure of an aortic dissection of a patient, having an ascending aorta portion, an aortic arch portion, a thoracic aorta portion, an abdominal aorta portion, a dissection portion, and an arterial branch portion.
The ascending aorta branch in the aortic dissection model is connected with a pulsation pump, and under the action of the pulsation pump, working media such as water, Phosphate Buffer Solution (PBS) and simulated blood can flow in the aortic dissection model to generate pulsating pressure similar to a blood pressure curve of a patient, so that the flow of the blood of the patient in the surgical process can be simulated. Before the operation simulation is performed, it is necessary to acquire blood pressure data of the patient and control the pulsation pump to operate based on the blood pressure data so that the pressure of the working medium such as the simulated blood in the model matches the blood pressure of the patient.
Step A40, arranging a pressure sensor on the inner side of the vessel wall of the aorta of the aortic dissection model, and arranging a flow sensor at the outlet of the artery branch of the aortic dissection model.
The pressure sensor patient acquires pressure data of a blood vessel wall in the process of working medium circulation, and the flow sensor acquires flow data of the working medium flowing through the branch and transmits the acquired pressure data and flow data to an external analysis system or analysis software.
Specifically, in the present embodiment, the step a40 of setting the pressure sensor on the inner side of the vessel wall of the aorta of the aortic dissection model specifically includes:
determining the number and the positions of pressure sensors to be placed in the aortic dissection model according to the position relation of a false cavity of the aortic dissection and a thoracic aorta and an abdominal aorta in the aortic dissection model; placing the pressure sensors on the aortic dissection model in the determined number and location.
The pressure sensor comprises two parts, namely a sheet-shaped pressure sensor and a data transmission line. The sheet-shaped pressure sensor is made of soft materials and can be completely attached to the wall surface of a simulated blood vessel of the model, and the surface of the pressure sensor is provided with a waterproof layer, so that the pressure sensor can work in the environment wrapped by liquid. The data transmission line is led out from the interface between the sensor and the wall surface of the aortic dissection model, the wiring mode of the data transmission line is determined according to the position of the pressure sensor, and the data transmission line is connected to an industrial personal computer provided with an analysis system or analysis software.
In this embodiment, the number and positions of the pressure sensors to be placed in the aortic dissection model are determined according to the position relationship between the prosthetic cavities of the aortic dissection and the thoracic aorta and the abdominal aorta in the aortic dissection model; placing the pressure sensors on the aortic dissection model according to the determined number and position, specifically comprising:
when the lower port of the false cavity of the aortic dissection is positioned at the upper half section of the thoracic aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, and two pressure sensors are correspondingly arranged on the inner side of the tube wall at the tail end of the thoracic aorta.
When the lower port of the false cavity of the aortic dissection is positioned at the upper half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the true cavity at the tail end of the thoracic aorta, and two pressure sensors are correspondingly arranged in the false cavity.
When the lower port of the false cavity of the aortic dissection is positioned at the lower half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the tail end of the thoracic aorta, two corresponding pressure sensors are arranged on the inner side of the tube wall of the tail end of the abdominal aorta, and a pair of pressure sensors are correspondingly arranged in the middle and the lower part of the inner side of the tube wall in the false cavity respectively.
The above-mentioned wiring mode of confirming the data transmission line according to the pressure sensor position specifically includes:
when the pressure sensor is positioned outside the true lumen and the false lumen of the non-aortic dissection part or the aortic dissection part, the data transmission line is led out by the sensor and then directly penetrates through the tube wall of the aortic dissection model.
When the pressure sensor is located on the inner layer (i.e., the intima sheet) of the aortic dissection, the data transmission line enters the dissection membrane and passes out of the tube wall from the side along the dissection membrane.
In an embodiment of the present application, in the step a40, the setting of the flow sensor at the outlet of the arterial branch of the aortic dissection model specifically includes:
ultrasonic flow meters are correspondingly arranged at branch outlets of the innominate artery, the left common carotid artery, the left subclavian artery, the celiac trunk artery, the superior mesenteric artery, the left renal artery, the right renal artery, the left common iliac artery and the right common iliac artery of the aortic dissection model.
Furthermore, the aortic dissection model established by the method provided by the embodiment of the application can accurately detect the potential risks in the simulated operation process through the pressure sensor and the flow sensor, and then doctors can optimize the operation scheme according to the data acquired by the pressure sensor and the flow sensor.
In the embodiment, the aortic dissection model is established according to different CTA data of the patient, so that the individual treatment of the aortic dissection patient can be realized, the aortic dissection is complex and changeable in shape and has large disease difference, and a doctor can be guided to select a reasonable operation scheme and improve the individual interventional operation skill of the patient through the individual customization of the aortic dissection model and the effective feedback report of software.
In yet another embodiment of the present application, there is provided an aortic dissection model made using the method as described in any of the possible embodiments above. The aortic dissection model comprises: an ascending aorta portion, an aortic arch portion, a thoracic aorta portion, an abdominal aorta portion, a sandwich portion, and an arterial branch portion; the wall of the aorta is provided with a pressure sensor, and the branch outlet of the artery branch part is provided with a flow sensor.
Fig. 1 is a schematic structural diagram of an aortic dissection according to an embodiment of the present disclosure, and referring to fig. 1, in this embodiment, when a lower port 7 of a prosthetic lumen 5 of the aortic dissection is located in an upper half section of a thoracic aorta 3, two pressure sensors 4 are correspondingly disposed on an inner side of a tube wall of a middle-posterior section of an aortic arch 2, and the two pressure sensors are disposed oppositely. Two pressure sensors are correspondingly arranged on the inner side of the tube wall at the tail end of the thoracic aorta 3.
Fig. 2 is a schematic structural view of another aortic dissection provided in this embodiment, and referring to fig. 2, in this embodiment, when a lower port of a prosthetic lumen 5 of the aortic dissection is located in an upper half section of an abdominal aorta 1, two pressure sensors 4 are correspondingly arranged on an inner side of a tube wall of a posterior section of an aortic arch 2, two pressure sensors are correspondingly arranged on an inner side of a tube wall of a true lumen at a tail end of a thoracic aorta 3, and two pressure sensors are correspondingly arranged in the prosthetic lumen 5.
Fig. 3 is a schematic structural diagram of another aortic dissection provided in this embodiment, and referring to fig. 3, in this embodiment, when a lower port of a prosthetic lumen 5 of the aortic dissection is located in a lower half section of an abdominal aorta 1, two pressure sensors 4 are correspondingly arranged on an inner side of a tube wall of a posterior section in an aortic arch 2, two pressure sensors are correspondingly arranged on an inner side of a tube wall of a distal end of a thoracic aorta 3, two corresponding pressure sensors are arranged on an inner side of a tube wall of a distal end of the abdominal aorta 1, and a pair of pressure sensors are correspondingly arranged in a middle portion and a lower portion of an inner side of a tube wall in the prosthetic lumen, respectively.
In an embodiment of the present invention, the artery branch portion includes: innominate artery branch, left common carotid artery branch, left subclavian artery branch, celiac trunk artery branch, superior mesenteric artery branch, left renal artery branch, right renal artery branch, left common iliac artery branch and right common iliac artery branch. Ultrasonic flow meters are respectively arranged at branch outlets of the innominate artery branch, the left common carotid artery branch, the left subclavian artery branch, the celiac trunk artery branch, the superior mesenteric artery branch, the left renal artery branch, the right renal artery branch, the left common iliac artery branch and the right common iliac artery branch.
It should be noted that the number of arterial branches may vary from patient to patient.
In another embodiment of the present application, a method for monitoring an aortic dissection repair simulated surgery is provided, fig. 4 is a schematic flow chart of the method for monitoring an aortic dissection repair simulated surgery provided in an embodiment of the present application, and as shown in fig. 4, the method includes the following steps S101 to S104:
step S101, after a simulated operation is started, acquiring pressure data and flow data which are respectively acquired by each pressure sensor and each flow sensor on the model of the aortic dissection in the simulated operation process, wherein the pressure data carries an identifier of the pressure sensor, and the flow data carries an identifier of the flow sensor.
Step S102, after the simulated operation is finished, enabling each pressure sensor and each flow sensor to acquire steady-state data within a preset time, and storing the data acquired by each pressure sensor and each flow sensor.
And S103, generating an operation report according to the stored data acquired by each pressure sensor and each flow sensor.
In this embodiment, the stored data collected by the pressure sensor and each flow sensor is divided into two parts, namely, simulated surgery process data and simulated surgery result data, and then analyzed.
The simulated operation process data is the data collected by the flow sensor from the beginning of the simulated operation to the end of the simulated operation.
And (c) the simulated operation result data, namely transient steady-state data collected by each pressure sensor and each flow sensor after the simulated operation is finished. Preferably, the simulation model simulates the data collected by the flow sensor in a time period of 5-10 s after the operation is finished.
In an embodiment of the present application, the generating of the surgical report further includes the following steps B10-B30 and C10-C30:
and step B10, comparing the acquired pressure data acquired by each pressure sensor in the simulated operation process with a preset first data threshold range respectively to obtain a first comparison result in the simulated operation process.
According to the material mechanics experiment, the blood vessel is ruptured under the pressure of 400-760 mmHg. The first threshold range may be set to 0-400 mmHg.
And step B20, comparing the acquired simulated operation result pressure data acquired by each pressure sensor with a preset second data threshold range respectively to obtain a second comparison result of the simulated operation result.
And step B30, comparing the acquired flow data of the simulated operation process and the acquired flow data of the simulated operation result acquired by each flow sensor with a preset third data threshold range respectively to obtain a third comparison result of the simulated operation process and a third comparison result of the simulated operation result.
Step C10, judging a first risk degree of vascular rupture at the position where the pressure sensor is located according to the first comparison result;
step C20, judging a first risk degree of vascular rupture and a second risk degree of thrombus growth at the position where the pressure sensor is positioned according to the second comparison result;
step C30, according to the third comparison result, judging a third risk degree that the organ supplied with blood by the artery branch corresponding to the artery branch outlet where the flow sensor is located is in a transient ischemia state;
in this embodiment, in step S103, the generating a surgical report according to the stored data acquired by each pressure sensor and each flow sensor includes:
after the simulated surgery is finished, generating a surgery report according to the stored data collected by each pressure sensor and each flow sensor, the first comparison result, the second comparison result, the third comparison result, the first risk degree, the second risk degree and the third risk degree.
And step S104, outputting the operation report.
The surgical report includes simulated surgical procedure evaluation content and simulated surgical result evaluation content.
The surgical procedure evaluation content includes: the degree of risk of a rupture (or secondary breach) occurring during the surgical procedure (first risk) derived from the simulated surgical procedure pressure data; specifically, when the first comparison result in the simulated operation process shows that the pressure of the pressure sensor at a certain position is higher than the first data threshold range, the first risk degree is high, and if the certain position is on the inner membrane of the aortic dissection, the first risk degree is output in a simulated operation report: during the simulated surgery, where the pressure is above the normal range, there is a risk of creating a secondary breach. If the position is on the outer vessel wall surface of the aortic dissection model, the following is output in a simulated operation report: there is a risk of vascular rupture during simulated surgery where the pressure is higher than normal.
When the first comparison result of the simulated operation process shows that the pressure of the pressure sensor at a certain position is in a first data threshold range, the first risk degree is low, and the following steps are output in a simulated operation report: the pressure is within normal values at this point during the simulated surgery, and the risk of vascular rupture is low.
The degree of risk of organ ischemia during surgery (third risk) from the simulated surgical procedure flow data; specifically, when the third comparison result in the simulated operation process shows that the flow of a branch flow sensor is in the third data threshold range, the third risk degree is low, and the third risk degree is output in the simulated operation report: the flow rate of the branch is in the normal range during the simulated surgery and there is no risk of the organ supplied by the branch being in a transient ischemic state.
When the third comparison result in the simulated operation process shows that the flow of a certain branch flow sensor is lower than the third data threshold range, the third risk degree is high, and the third risk degree is output in a simulated operation report: the flow rate of the branch is lower than normal during the simulated surgery, and there is a risk that the organ supplied by the branch is in a transient ischemic state.
The operation result evaluation content comprises:
a degree of risk of rupture (or secondary breach) occurring after surgery (first risk) and a degree of risk of thrombus formation (second risk) derived from the post-operative pressure data; specifically, when the second comparison result of the simulated operation result shows that the pressure of the pressure sensor at a certain position is higher than the second data threshold range, the first risk degree is high. If the position is on the inner membrane of the aortic dissection, the following is output in a simulated operation report: after the simulated surgery is over, where the pressure sensor pressure is above the normal range of values, there is a risk of creating a secondary breach. If the position is on the outer vessel wall surface of the aortic dissection model, the following is output in a simulated operation report: there is a risk of vascular rupture during simulated surgery where the pressure is higher than normal.
When the second comparison result of the simulated operation result shows that the pressure of the pressure sensor at a certain position is lower than the second data threshold range, the second risk degree is high, and the following steps are output in the simulated operation report: after the simulated surgery is completed, there is a risk of thrombus formation.
When the second comparison result of the simulated operation process shows that the pressure of the pressure sensor at a certain position is in the second data threshold range, the first risk degree and the second risk degree are both low, and the first risk degree and the second risk degree are output in a simulated operation report: the pressure at this point during the simulated surgery is within normal values, the risk of vascular rupture is low, and the risk of thrombus formation is low.
The degree of risk of post-operative organ ischemia (third risk) derived from post-operative flow data; specifically, when the third comparison result in the simulated operation process shows that the flow rate of a certain branch flow sensor is lower than the third data threshold range, the third risk degree is high, and the third risk degree is output in the simulated operation report: after the simulated surgery is finished, the branch flow rate is lower than the normal value range, and the organ supplied with blood by the branch may have acute ischemia symptoms.
When the third comparison result in the simulated operation process shows that the flow of a certain branch flow sensor is in the third data threshold range, the third risk degree is low, and the third risk degree is output in a simulated operation report: after the simulated operation is finished, the branch flow is lower than the normal value range, and the organ supplied with blood by the branch does not have acute ischemia symptom.
In the above embodiment, when a doctor performs personalized preoperative training for aortic dissection endoluminal repair, CTA and blood pressure data of a patient are collected, the dissection length of the patient is judged according to the CTA data, a corresponding model configuration scheme is selected, and a personalized model of the patient is manufactured after three-dimensional reconstruction and post-processing; then, an interventional operation simulation system is used for carrying out simulated operation, and a data acquisition system acquires and stores data such as pressure, flow and the like generated in the process of the simulated operation; after the simulated operation is finished, analyzing the pressure and flow data collected in the process of the simulated operation by data analysis software of the aortic dissection endoluminal prosthesis to generate a simulated operation report; after the simulated operation, the doctor improves the operation according to the generated simulated operation report.
It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus once an item is defined in one figure, it need not be further defined and explained in subsequent figures, and moreover, the terms "first", "second", "third", etc. are used merely to distinguish one description from another and are not to be construed as indicating or implying relative importance.
Finally, it should be noted that: the above-mentioned embodiments are only specific embodiments of the present invention, which are used for illustrating the technical solutions of the present invention and not for limiting the same, and the protection scope of the present invention is not limited thereto, although the present invention is described in detail with reference to the foregoing embodiments, those skilled in the art should understand that: any person skilled in the art can modify or easily conceive the technical solutions described in the foregoing embodiments or equivalent substitutes for some technical features within the technical scope of the present disclosure; such modifications, changes or substitutions do not depart from the spirit and scope of the present invention in its spirit and scope. Are intended to be covered by the scope of the present invention. Therefore, the protection scope of the present invention shall be subject to the protection scope of the claims.
Claims (9)
1. A method of constructing a model of an aortic dissection, comprising:
obtaining CTA image data of a patient's aorta;
establishing a three-dimensional model of an aortic dissection according to the obtained CTA image data of the aorta of the patient;
3D printing is carried out according to the three-dimensional model, and the aortic dissection model is made of transparent materials consistent with the elasticity of the blood vessels of the patient;
arranging a pressure sensor on the inner side of the tube wall of the aorta of the aortic dissection model, and arranging a flow sensor at the outlet of the arterial branch of the aortic dissection model;
the pressure sensor comprises a sheet-shaped pressure sensor and a data transmission line;
the setting of the pressure sensor on the aortic dissection model comprises:
determining the number and the positions of pressure sensors to be placed in the aortic dissection model according to the position relation of a false cavity of the aortic dissection and a thoracic aorta and an abdominal aorta in the aortic dissection model; placing the pressure sensors on the aortic dissection model in the determined number and position;
the aortic dissection model has an ascending aorta portion, an aortic arch portion, a thoracic aorta portion, an abdominal aorta portion, a dissection portion, and an arterial branch portion;
the ascending aorta portion is connected with a pulsatile pump for operating in accordance with blood pressure data of a patient.
2. The method according to claim 1, wherein the number and positions of pressure sensors to be placed in the aortic dissection model are determined according to the positional relationship of the prosthetic lumen of the aortic dissection with the thoracic aorta and the abdominal aorta in the aortic dissection model; placing the pressure sensors on the aortic dissection model in the determined number and location, comprising:
when the lower port of the false cavity of the aortic dissection is positioned at the upper half section of the thoracic aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, and two pressure sensors are correspondingly arranged on the inner side of the tube wall at the tail end of the thoracic aorta;
when the lower port of the false cavity of the aortic dissection is positioned at the upper half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the true cavity at the tail end of the thoracic aorta, and two pressure sensors are correspondingly arranged in the false cavity;
when the lower port of the false cavity of the aortic dissection is positioned at the lower half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the tail end of the thoracic aorta, two corresponding pressure sensors are arranged on the inner side of the tube wall of the tail end of the abdominal aorta, and a pair of pressure sensors are correspondingly arranged in the middle and the lower part of the inner side of the tube wall in the false cavity respectively.
3. The method according to claim 1, wherein the disposing a flow sensor at an outlet of an arterial branch of the aortic dissection model comprises:
ultrasonic flow meters are correspondingly arranged at branch outlets of the innominate artery, the left common carotid artery, the left subclavian artery, the celiac trunk artery, the superior mesenteric artery, the left renal artery, the right renal artery, the left common iliac artery and the right common iliac artery of the aortic dissection model.
4. An aortic dissection model made by the method of any one of claims 1 to 3, comprising: an ascending aorta portion, an aortic arch portion, a thoracic aorta portion, an abdominal aorta portion, a sandwich portion, and an arterial branch portion; a pressure sensor is arranged on the wall of the aorta, and a flow sensor is arranged at the branch outlet of the arterial branch part; the pressure sensor comprises a sheet-shaped pressure sensor and a data transmission line;
the setting of the pressure sensor on the aortic dissection model comprises:
determining the number and the positions of pressure sensors to be placed in the aortic dissection model according to the position relation of a false cavity of the aortic dissection and a thoracic aorta and an abdominal aorta in the aortic dissection model; placing the pressure sensors on the aortic dissection model in the determined number and position;
the aortic dissection model has an ascending aorta portion, an aortic arch portion, a thoracic aorta portion, an abdominal aorta portion, a dissection portion, and an arterial branch portion;
the ascending aorta portion is connected with a pulsatile pump for operating in accordance with blood pressure data of a patient.
5. The aortic dissection model of claim 4, wherein when the lower port of the prosthetic lumen of the aortic dissection is located in the upper half of the thoracic aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle-posterior segment of the aortic arch, and two pressure sensors are correspondingly arranged on the inner side of the tube wall of the tail end of the thoracic aorta;
when the lower port of the false cavity of the aortic interlayer is positioned at the upper half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the true cavity at the tail end of the thoracic aorta, and two pressure sensors are correspondingly arranged in the false cavity;
when the lower port of the false cavity of the aortic dissection is positioned at the lower half section of the abdominal aorta, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the middle and rear section of the aortic arch, two pressure sensors are correspondingly arranged on the inner side of the tube wall of the tail end of the thoracic aorta, two corresponding pressure sensors are correspondingly arranged on the inner side of the tube wall of the tail end of the abdominal aorta, and a pair of pressure sensors is correspondingly arranged at the middle part and the lower part of the inner side of the tube wall in the false cavity respectively.
6. The aortic dissection model of claim 4, wherein the arterial branch portion comprises: innominate artery branch, left common carotid artery branch, left subclavian artery branch, celiac trunk artery branch, superior mesenteric artery branch, left renal artery branch, right renal artery branch, left common iliac artery branch and right common iliac artery branch; ultrasonic flow meters are respectively arranged at the score outlets of the innominate artery branch, the left common carotid artery branch, the left subclavian artery branch, the celiac trunk artery branch, the superior mesenteric artery branch, the left renal artery branch, the right renal artery branch, the left common iliac artery branch and the right common iliac artery branch.
7. A method for monitoring aortic dissection repair simulation surgery, wherein the aortic dissection repair simulation surgery is performed on a model of the aortic dissection, and a pressure sensor is arranged on the model, wherein the pressure sensor is arranged on the model, and the method comprises the following steps:
determining the number and the positions of pressure sensors to be placed in the aortic dissection model according to the position relation of a false cavity of the aortic dissection and a thoracic aorta and an abdominal aorta in the aortic dissection model; placing the pressure sensors on the aortic dissection model in the determined number and position;
the aortic dissection model has an ascending aorta portion, an aortic arch portion, a thoracic aorta portion, an abdominal aorta portion, a dissection portion, and an arterial branch portion;
the ascending aorta part is connected with a pulse pump which is used for working according to the blood pressure data of the patient;
the monitoring method comprises the following steps:
after a simulated operation starts, acquiring pressure data and flow data which are respectively acquired by each pressure sensor and each flow sensor on the model of the aortic dissection in the simulated operation process, wherein the pressure data carries an identifier of the pressure sensor, and the flow data carries an identifier of the flow sensor; the pressure sensor comprises a sheet-shaped pressure sensor and a data transmission line;
after the simulation operation is finished, enabling each pressure sensor and each flow sensor to acquire steady-state data within a preset time, and storing the data acquired by each pressure sensor and each flow sensor;
after the data storage is finished, generating a surgical report according to the stored data collected by each pressure sensor and each flow sensor;
and outputting the operation report.
8. The method of claim 7, further comprising:
comparing the acquired pressure data of the simulated operation process acquired by each pressure sensor with a preset first data threshold range respectively to obtain a first comparison result of the simulated operation process;
comparing the acquired pressure data of the simulated operation result acquired by each pressure sensor with a preset second data threshold range respectively to obtain a second comparison result of the simulated operation result;
comparing the acquired flow data of the simulated operation process and the acquired flow data of the simulated operation result acquired by each flow sensor with a preset third data threshold range respectively to obtain a third comparison result of the simulated operation process and a third comparison result of the simulated operation result;
after the simulated surgery is finished, generating a surgery report according to the stored data collected by each pressure sensor and each flow sensor, wherein the method comprises the following steps:
after the simulated operation is finished, judging the simulated operation process and the possible risks after the simulated operation according to the stored data collected by each pressure sensor and each flow sensor, the first comparison result, the second comparison result and the third comparison result.
9. The method of claim 8, further comprising:
judging a first risk degree of vascular rupture at the position where the pressure sensor is located according to the first comparison result;
judging a first risk degree of vascular rupture and a second risk degree of thrombus growth at the position where the pressure sensor is located according to the second comparison result;
judging a third risk degree of the organ supplied with blood by the artery branch corresponding to the artery branch outlet where the flow sensor is positioned in a transient ischemic state according to the third comparison result;
after the simulated surgery is finished, generating a surgery report according to the stored data collected by each pressure sensor and each flow sensor, wherein the method comprises the following steps:
after the simulated surgery is finished, generating a surgery report according to the stored data collected by each pressure sensor and each flow sensor, the first comparison result, the second comparison result, the third comparison result, the first risk degree, the second risk degree and the third risk degree.
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